CLINICAL-EVALUATION OF A NEWLY DESIGNED NASOGASTRIC ENTERAL FEEDING TUBE

Concerned with reports in the literature of a rising incidence of ente ral feeding tube clogging, we initiated a design programme in an attem pt to improve the clinical efficacy of nasogastric and nasoenteric ent eral feeding tubes. Tube design has been based on a remodelling of the outflow part of a polyurethane feeding tube previously developed in o ur unit. The tip of the newly designed 8F enteral feeding tube is shor ter in length with a rounded end to minimize discomfort during intubat ion. The port itself incorporates a tapered outflow design with the si de walls now extending below the mid-point of the internal flow lumen resulting in a 28% increase in port area compared to the equivalent an d originally designed tube. The performance of the newly designed poly urethane feeding tube was assessed under controlled trial conditions u sing as references two widely used 8F polyurethane nasogastric feeding tubes whose design has been based on different principles (Flexiflo, weighted tip, open-ended with two side ports; Freka, occluded tip, two simple large side ports). Eighty-eight of 90 patients entered into th e study were successfully intubated with no significant differences be ing noted in intubation times in the three groups. Significantly less discomfort occurred during intubation of patients with the Radius tube as compared to the Freka tube (P < 0.05). Although there were no clea r differences between the Flexiflo and Freka tubes either in regard to the number of attempts required for intubation or aspiration or disco mfort during intubation or ease of aspiration, fewer attempts at inser tion and aspiration were needed and intubation and aspiration were eas ier for patients randomised to the Radius group than those to the Flex iflo and Freka groups (P < 0.05). We conclude that the clinical perfor mance of the newly designed Radius enteral feeding tube compares favou rably with that of the reference tubes. Only one of the new tubes (3.3 %) blocked during the course of the study. High rates of non-elective extubation were observed in the three study groups (Radius 80.0%, Flex iflo 73.3%, Freka 73.3%). Design modifications are unlikely to influen ce non-elective nasogastric feeding tube extubation rates which remain a major clinical problem.